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Background: To evaluate the clinical performance of universal adhesives in etch-and-rinse or self-etch application modes through meta-analysis., Methods: A literature search was performed by two reviewers in the PubMed, Cochrane Library, and Embase databases (from January 2000 to March 2020). A total of 2,516 non-replicated records were identified and filtered. Studies that evaluated the clinical performance of universal adhesives using etch-and-rinse or self-etch mode were included. RevMan 5.3.5 (Cochrane, London, UK) was used to perform the meta-analysis., Results: A total of 13 studies were included in the meta-analysis. The retention rates were higher in etch-and-rinse groups compared with self-etch groups [odds ratio (OR) =0.35, 95% confidence interval (CI): 0.18-0.71, P=0.003]. The etch-and-rinse approach also had better performance in marginal adaptation (OR =0.49, 95% CI: 0.36-0.67, P<0.001) and marginal staining (OR =0.49, 95% CI: 0.36-0.66, P<0.001). The current data showed a very low incidence rate of secondary caries or postoperative sensitivity, and there were no significant differences in the incidence rates between the etch-and-rinse groups and self-etch groups., Discussion: The current evidence shows that, compared with self-etch approach, the etch-and-rinse approach for universal adhesives provides improved clinical outcomes in terms of retention rates, marginal adaptation, and marginal staining.

Aims: The effect of mechanical loading on the microtensile bond strength (μTBS) of universal adhesives to dentin was evaluated in this study., Methods and Materials: Human molar teeth had the occlusal dentin surfaces exposed and were allocated into ten groups (five experimental groups and five control groups) that used the following universal adhesive systems in self-etch mode: All-Bond Universal (ABU), Single Bond Universal (SBU), Gluma Bond Universal (GBU), Tetric N-Bond Universal (TBU), and Clearfil Universal Bond (CUB). Following the bonding procedures and build-ups, the specimens were either stored in water at 37°C for 24 h or were mechanically loaded (50 N for 60,000 cycles) prior to the μTBS test. Data were analyzed using the one-way analysis of variance (ANOVA) and Tukey's posthoc test (P = 0.05)., Results: Both the adhesive type and mechanical loading had significant effects on the μTBS (P < 0.05). The μTBS values of SBU and ABU were significantly higher than the values of the other adhesives (P < 0.05). However, the μTBS values of ABU decreased significantly after mechanical loading (P < 0.05)., Conclusions: With the exception of ABU, mechanical loading had no deleterious effects on the μTBS of the universal adhesive systems examined in this study., Competing Interests: None

Objectives: A systematic review and meta-analysis were performed to compare longevity of Self-Etch Dentin Bonding Adhesives to Etch-and-Rinse Dentin Bonding Adhesives., Material and Methods: The following databases were searched for PubMed, MEDLINE, Web of Science, CINAHL, the Cochrane Library complemented by a manual search of the Journal of Adhesive Dentistry. The MESH keywords used were: "etch and rinse," "total etch," "self-etch," "dentin bonding agent," "bond durability," and "bond degradation." Included were in-vitro experimental studies performed on human dental tissues of sound tooth structure origin. The examined Self-Etch Bonds were of two subtypes; Two Steps and One Step Self-Etch Bonds, while Etch-and-Rinse Bonds were of two subtypes; Two Steps and Three Steps. The included studies measured micro tensile bond strength (μTBs) to evaluate bond strength and possible longevity of both types of dental adhesives at different times. The selected studies depended on water storage as the aging technique. Statistical analysis was performed for outcome measurements compared at 24 h, 3 months, 6 months and 12 months of water storage., Results: After 24 hours (p-value = 0.051), 3 months (p-value = 0.756), 6 months (p-value=0.267), 12 months (p-value=0.785) of water storage self-etch adhesives showed lower μTBs when compared to the etch-and-rinse adhesives, but the comparisons were statistically insignificant., Conclusion: In this study, longevity of Dentin Bonds was related to the measured μTBs. Although Etch-and-Rinse bonds showed higher values at all times, the meta-analysis found no difference in longevity of the two types of bonds at the examined aging times., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: The aim of the study was to assess a one-step self-etch adhesive (Futurabond M, 1-SE) and a two-step etch-and-rinse adhesive (Solobond M, 2-ER) used in combination with the nano-hybrid composite (Amaris) in a prospective clinical study on non-carious cervical lesions., Methods: 110 restorations were placed in 40 patients and graded over 36 months according to aesthetical, functional and biological criteria (Clinical Oral Investigations 2007;11:5). The four-step etch-and-rinse adhesive Syntac classic (4-ER) combined with the nano-hybrid composite Tetric EvoCeram was used as a control. Cumulative failure rates (CFR), retention rates and Kaplan-Meier survival curves were calculated for each observation period., Results: After 3 years, the CFR of 33.3% in the 2-ER group was significantly higher compared to those of the 1-SE group (9.1%, p = 0.019) and of the 4-ER group (8.3%, p = 0.035). Additionally, retention rates in the 1-SE and the 4-ER groups were higher compared to 2-ER (p = 0.012 each) after 36 months. Annual failure rates ranged between 2.8% for 4-ER, 3.0% for 1-SE and 11.1% for 2-ER. During the study, restorations in all groups showed progressive marginal deterioration within the limits of clinical acceptance. After 3 years, restorations in the 2-ER and the 4-ER group showed more small defects at dentin than at enamel margins., Conclusions: The 1-SE group was clinically as successful as the 4-ER, with both performing better than the 2-ER group. Futurabond M/Amaris can be recommended for the restoration of sclerotic non-carious cervical lesions., Clinical Significance: Number protocol 192/2008., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Universal adhesives (UAs) often exhibit comparable or even superior bond strength to traditional adhesive systems, ensuring reliable and long-lasting adhesion between the resin composite and the tooth structure. Therefore, this study aimed to assess the clinical performance of UAs compared to other adhesive systems in direct resin composite restorations through a systematic review and meta-analysis. Two reviewers executed a literature search in five electronic databases: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Clinical trials comparing the clinical evaluation of resin composite restorations in Class I, Class II, or Class V cavities placed with an universal adhesive (UA) system against resin composite restorations placed with another non-UA system were included in the review. An analysis was carried out using Review Manager software version 5.3.5 (London, England, United Kingdom). Standardized effect sizes with 95% confidence intervals were calculated to allow comparisons between different interventions and different outcomes. The methodological quality of each study was assessed using the Cochrane RoB2 tool for randomized clinical trials. A total of 2331 potentially relevant studies were identified. After title and abstract examination, 14 studies remained in the systematic review. From these, a total of 11 studies were included in the meta-analysis. The retention rates of resin composite restorations after 6 months showed no significant difference between total-etch (TE, p=0.83), or self-etch (SE, p=0.78) adhesives and UAs applied in TE and SE modes (p>0.05). However, UAs applied in selective-enamel etching (SEE) mode demonstrated superior clinical performance compared to other adhesives (p=0.01), particularly TE adhesives (p=0.02). Similarly, after >12 months of follow-up, there were no significant differences in retention rates among different adhesive modes (p>0.05). Additionally, the incidence of secondary caries did not significantly differ across adhesive modes at both 6-month and >12-month evaluations (p>0.05). This systematic review and meta-analysis suggested that UAs demonstrate comparable clinical performance to TE and SE adhesive systems in direct resin composite restorations, particularly in terms of restoration retention rates and the incidence of secondary caries. UAs applied in SEE mode exhibited superior clinical outcomes compared to other adhesive systems. These findings indicate that UAs can be considered a viable alternative to traditional adhesive systems in clinical practice, offering flexibility in application while maintaining comparable long-term outcomes. [ABSTRACT FROM AUTHOR]

Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram/Ivoclar/Vivadent), bonded with a total-etch adhesive agent (ExciTE F/Ivoclar/Vivadent) and a self-etch (AdheSE One F/Ivoclar/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen's kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years. [ABSTRACT FROM AUTHOR]

Red-fluorescing dentine indicates bacterial contamination [Caries Res 2002; 36: 315–319]. We investigated effect of removal of red fluorescent dentine caries on shear bond strength and fracture mode of 4 adhesive approaches. Sixty-five carious teeth and 50 noncarious controls were distributed into 4 groups: Clearfil™ self-etch (CSE), OptiBond™ FL total etch (OTE), Scotchbond™ Universal total etch (STE) and self-etch (SSE). Samples were excited at 405 nm and viewed through 530 nm filter. Carious samples were ground flat exposing strongly red-fluorescing (StrongRF) dentine, on which a composite cylinder was placed, using one of 4 adhesives. After 22 h in water, shear bond strength and fracture mode were analysed. StrongRF was removed; composite cylinders were placed on weakly red-fluorescing (WeakRF) dentine and tested as described above. Finally, red-fluorescing dentine was removed, and composite cylinders were placed on non-fluorescing (NonRF) dentine and tested. Composites were placed at 3 corresponding heights in controls. After 22 h in water, shear bond strength testing and fracture mode analysis were performed. Differences were tested using Mann-Whitney or Wilcoxon tests (p ≤0.05). Median (Q1, Q3) shear bond strength on StrongRF was SSE 14.4 (9.2, 18.2) MPa >CSE 10.2 (6.4, 17.3) MPa >STE 9.1 (6.9, 11.2) MPa >OTE 6.8 (4.0, 10.8) MPa. Shear bond strength increased statistically significantly for all adhesives on WeakRF: SSE 19.8 (13.6, 24.3) MPa >STE 19.5 (12.7, 23.1) MPa >CSE 17.5 (12.0, 22.5) MPa >OTE 15.8 (11.9, 20.9) MPa. Only STE 25.6 (22.4, 29.1) MPa and CSE 22.1 (17.6, 24.6) MPa were significantly different on NonRF compared to WeakRF. For controls tested at corresponding depths, superficial shear bond strength was OTE 18.7 (16.0, 22.1) MPa >STE 18.4 (12.0, 25.9) MPa >CSE 18.1 (12.7, 20.7) MPa >SSE 13.0 (9.6, 17.8) MPa. This was significantly higher compared to StrongRF except for SSE. Central shear bond strength was not significantly different to WeakRF, deep shear bond strength was significantly lower for SSE and CSE but higher for OTE compared to carious. Conclusion: StrongRF dentine should be removed for higher shear bond strength, but WeakRF dentine can often be preserved without compromising adhesive bond strength. [ABSTRACT FROM AUTHOR]

To examine whether dentin-etching extension and/or the hydrophobic-rich content of hybrid layers would affect fatigue strengths of a mild universal adhesive after long-term aging. Twin-bonded resin-dentin interfaces were produced by etching sound midcoronal dentin beams with 32 % ortho-phosphoric acid for 15 s (OPA15s), 3 s (OPA3s) or 10 % meta-phosphoric acid for 15 s (MPA15s). Samples were bonded with a mild universal adhesive with or without additional coating using a solvent-free bisGMA-based bonding resin. Self-etch application served as control. Composite buildups were made with a nanofilled composite. Bar-shaped twin-bonded interfaces (0.9 × 0.9 × 12 mm) were aged for two years in artificial saliva at 37 ℃ and tested under 4-point flexure at quasi-static (n = 16) and cyclic loads (n = 35) until failure. The stress-life fatigue behavior was evaluated using the staircase method at 4 Hz. Crack initiation and fracture patterns were evaluated by SEM. Cyclic-loaded data was analyzed by Kruskal-Wallis on Ranks (α = 0.05). Significantly higher fatigue life distributions and higher endurance limits were observed for less aggressive etch-and-rinse protocols (OPA3s and MPA15s) after long-term ageing. Hydrophobic-rich coating produced 20–32 % higher endurance limits, prevented micrometer-sized porosities at bonded interfaces, reduced etching-associated variability and lowered crack formation. Significance Long-term hydrolysis produces detrimental effects on the fatigue strength of resin-dentin interfaces. The bond-promotion effect of less aggressive etch-and-rinse protocols and the creation of hybrid layers with higher hydrophobic-rich content are critical to extend the durability of mild universal adhesives. Therefore, current oversimplification trends in adhesive dentistry may limit resin-dentin bonding performance. • Hydrolytic ageing renders improved assessment of resin-dentin fatigue strengths. • Long-term hydrolysis has detrimental effects on fatigue strengths. • Higher hydrophobicity of hybrid layers lower fatigue strength impairments over time. • It also lowers etching-associated variabilities after ageing. • Oversimplification of resin-dentin bonding protocols compromise interfacial quality. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate in vitro the effect of saliva contamination on bond strength of a universal adhesive applied with actively (with rubbing motion) and passively (without rubbing motion). Materials and Methods: A total of 144 bovine dentin samples were used, and the universal adhesive, Clearfil Universal Bond Quick, was either applied in accordance with the manufacturer's instructions (passive application) or applied with rubbing motion for 10 s (active application). These 2 groups were divided into 6 subgroups according to saliva contamination (n = 12): 1. control: etch-and-rinse (no saliva); 2. control: self-etch (no saliva); 3. etching/saliva/bonding; 4. etching/bonding/saliva; 5. saliva/bonding; 6. bonding/saliva. A resin composite, Filtek Ultimate, was filled into a polyethylene mold (0.9 mm diameter, 1.2 mm height) on the surfaces. Samples were subjected to microshear bond strength testing, and five specimens from each group were examined using SEM. Resin-dentin interfaces were also observed using transmission electron microscopy (TEM). All failure modes were determined using light microscopy. Statistical analyses were performed with two-way ANOVA, the Kruskall-Wallis test, and the Mann-Whitney U-test (p < 0.05). Results: Active-application groups showed statistically significantly higher bond strengths than did passive groups, regardless of adhesive strategy and saliva contamination (p < 0.05). Application of Clearfil Universal Bond Quick in self-etch mode with rubbing motion improved the µSBS among control groups (p < 0.05). The active application did not make a significant difference among the active groups (p > 0.05), except in group 2. Groups 2 and 5 showed significantly higher µSBS than group 3 among the passive groups (p < 0.05). Conclusion: Rubbing the universal adhesives without any prior etching may increase the dentin bond strength. Following etching, passive application of the universal adhesive (without any additional rubbing motion) could affect the bonding to dentin in the presence of saliva. [ABSTRACT FROM AUTHOR]

Context: The significance of enamel etching has been well-researched and established. Limited literature is available comparing the enamel bond strengths of the two-step self-etch adhesive system and the newly introduced universal adhesive (UA) system with prior acid etching. Aims: The aim of the study was to evaluate and compare the microtensile bond strength (μTBS) of composite to enamel with and without 37% orthophosphoric acid pre-etching using a recently introduced UA and a two-step self-etch adhesive. Subjects and Methods: This in vitro , experimental study was conducted on 48 extracted human third molar teeth. Two enamel surface fragments were obtained per tooth, polished using 600-grit silicon carbide abrasive paper, and randomly divided into four groups-CLEARFIL SE BOND with and without acid pre-etching and G-Premio Bond with and without acid pre-etching. The samples were etched using 37% phosphoric acid gel for 30 s, followed by the bonding protocol. Composite resin blocks were built incrementally to a thickness of approximately 6 mm, and the restored samples were stored in distilled water for 24 h at 37°C. They were then sectioned, mounted, and subjected to a μTBS test using a universal testing machine. Statistical Analysis Used: Statistical analysis of the data was performed using one-way ANOVA and Tukey's post hoc test using SPSS software version 22.0. Results: Samples bonded with the UA subjected to prior acid etching protocol demonstrated the highest enamel μTBS. In contrast, those treated with the two-step self-etch adhesive without prior acid etching demonstrated the lowest enamel μTBS. Pre-etching with phosphoric acid significantly increased the enamel bond strength of both bonding agents, with the universal agent showing better results than the two-step adhesive system. Conclusions: Enamel etching with phosphoric acid significantly increases the bond strength of self-etch adhesives. UA with prior acid etching showed the maximum enamel μTBS. Two-step self-etch adhesive without prior acid etching yielded enamel μTBSs unacceptable for long-term, durable bonding. [ABSTRACT FROM AUTHOR]

With the continuous development of adhesive technology leading to a wide variety of bonding systems in the market, clinicians are often faced with a vast number of systems to choose from. Although research and manufacture of bonding systems is constantly progressing, the focus has generally been on simplifying the bonding process by reducing the number of clinical steps, with little emphasis on evidence-based performance. This article draws attention to the current strategies of common commercially available products to guide clinicians during bonding system selection and application. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the effect of dentin pretreatment by Dimethyl Sulfoxide (DMSO) on the bond strength and microleakage of a universal bonding agent to dentin. Methods: Fifty-six dentinal discs (thickness = 2 mm) were obtained from the crowns of the human third molars. The disks were assigned into 4 groups and treated as follows; self-etch-control group: G-Premio universal adhesive was used in self-etch mode, total-etch-control: G-Premio universal adhesive was used in total-etch mode, self-etch-DMSO: Water-based DMSO (50% volume) was applied on the samples for 60 s followed by application of G-Premio universal adhesive in self-etch mode, and Total-etch-DMSO: The samples were etched, and then, water-based DMSO was applied on them for 60 s followed by the application of G-Premio universal adhesive in total-etch mode. Afterward, resin composite was placed on all samples and light-cured. The samples were kept in distilled water and subjected to 5000 thermal cycles. Microshear bond strength was measured using the universal testing machine and failure modes were analyzed using a stereomicroscope. Forty-eight human third molars were used for microleakage evaluation and a standardized class five cavity was prepared on the buccal surface of each tooth. The teeth were assigned into 4 groups and received aforementioned surface treatment and the cavities were filled with resin composite. After storing in water for 24 h, the samples were subjected to 5000 cycles of thermocycling and the microleakage level of the samples was evaluated using silver nitrate uptake at the bonded interface. Two-way ANOVA test was used to analyze the effect of bonding technique (self-etch/ total-etch) and DMSO pretreatment on the microshear bond strength and microleakage of G-Premio adhesive to dentin. Results: Bonding technique had no effect on the bond strength values (p = 0.17) while DMSO pretreatment significantly decreased the microshear bond strength of the samples (p = 0.001). DMSO application increased microleakage significantly in total-etch (P-value = 0.02) while it had no effect in self-etch mode (P-value = 0.44). Conclusions: Pretreatment of dentin using 50% DMSO significantly reduced the bond strength of G-Premio Bond in both self-etch and total-etch modes. DMSO effect on microleakage depended on the etching technique; DMSO increased the microleakage level when the adhesive was used in total-etch mode while did not affect the microleakage in self-etch mode. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this in vitro study was to compare the shear bond strength of different universal adhesives to enamel and dentin with and without additional phosphoric acid etching before and after thermocycling (TC). Materials and Methods: The mesial, distal, lingual, and buccal surfaces of the teeth were ground flat to expose two enamel areas and two dentin areas. Specimens were randomly divided into 36 groups (n = 10). Four adhesives were tested: Scotchbond Universal (SBU), Prime & Bond Elect (PBE), All-Bond Universal (ABU), and iBond Universal (IBU). The application was performed in the self-etch mode (SE) or in the etch-and-rinse mode (ER). Optibond FL (OFL) was used as an etch-and-rinse control. After composite buildups were made, half of the groups were tested before and the other half after TC. The failure mode was evaluated using a light microscope. Results: In enamel, mean bond strengths ranged from 13.4 to 21.9 MPa in the SE mode before TC. When used as an ER adhesive, mean bond strengths exceeded 30 MPa. TC did not influence the mean bond strengths in either application mode. Regarding dentin, significant differences in the SE mode were adhesive dependent. Differences were only detected between SBU and IBU before TC and were not present after TC. When SBU, PBE, and ABU were used as ER adhesives, no differences were detected before TC. TC only affected IBU when compared to the other adhesives. Conclusion: Universal adhesives benefit from phosphoric acid etching, as bond strengths increased especially at enamel surfaces. [ABSTRACT FROM AUTHOR]

Aims: The aim of the present study was to evaluate and compare the push-out bond strength of single and multiple fiber-reinforced posts cemented with dual-cure resin cement using total-etch and self-etch adhesive systems. Methods: Sixty single-rooted maxillary permanent incisors were decoronated and endodontically treated. Following post space preparations, the roots were divided into four groups (n = 15); Group 1: single fiber-reinforced composite post with the total-etching agent, Group 2: single fiber-reinforced composite post with the self-etching agent, Group 3: multiple pin posts with the total-etching agent, and Group 4: multiple pin posts with the self-etching agent and then cemented using dual-cure resin cement. The samples were then sectioned to obtain approximately 2-mm disks, and a push-out test was performed. Data obtained were statistically analyzed using analysis of variance, post hoc Tukey, and unpaired t-test. Results: The mean push-out bond strength values showed that Group 3 had significantly higher bond strength as compared to the other groups (P < 0.05). Conclusions: Dentapreg multiple pin posts with total-etching agents resulted in higher push-out bond strength as compared to single fiber-reinforced posts and self-etching agents. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical efficacy at 6 months (6 M) and 12 months (12 M) of 3 adhesive strategies (two-step etch-and-rinse; two-step self-etch; one step self-etch) used in composite resin restorations in primary molars. Methods: This randomized clinical study involved 101 class II restorations in primary molars of 34 children (4–8 years old), distributed by 3 groups according to the 3 tested adhesive systems: GI- ClearfilTMS3Bond Plus (CSB); GII- ClearfilTMSE Protect Bond (CSEPB); GIII- Prime&Bond®XP (PBXP). Restorations were evaluated according to FDI criteria, immediately after execution, at 6 M and 12 M. All ethical and legal requirements were met. Statistical analysis was performed using IBM®SPSS®v26 and MS Excel® (5% significance level). Results: The aesthetic, biological and most of the functional parameters evaluated remained without significant changes over time. Statistically significant differences were only found regarding the "marginal adaptation" parameter at 12 M, with worsening of scores for the three groups (p < 0.001). Comparing the groups, no significant differences were detected between any of the evaluated parameters (aesthetics properties: p = 0.721; functional properties: p = 0.122). Conclusions: After a one-year period, the self-etch adhesives tested presented a clinical efficacy similar to the etch-and-rinse adhesive in restoring class II cavities in primary molars. Trial registration number: ISRCTN11458186. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of water storage and cyclic loading on the microtensile bond strength (µTBS) and fracture pattern of adhesives to dentin. Materials and Methods: Midcoronal dentin surfaces (n = 36) were prepared and composite restorations were built up using two adhesives (self-etch and etch-and-rinse). The specimens were randomly divided into 3 groups according to the aging conditions (n = 6): 1. control: storage in water for 24 h (CO); 2. water storage: storage in water for 6 months (WS); 3. mechanical loading: 750,000 mechanical cycles (ML) using the Rub&Roll loading device. Specimens were sections into beams and the μTBS was tested. Fracture patterns were analyzed using stereomicroscopy and fractographic analysis was performed using SEM. μTBS data (n = 53-72 specimens) were subjected to two-way ANOVA and Tukey's post-hoc test. The chi-squared test was used to compare the distribution of failure modes (p < 0.05). Results: Aging conditions and adhesives significantly affected μTBS (p < 0.01). The CO group showed no difference between materials and had highest μTBS. After WS, the self-etch adhesive showed higher μTBS than did the etchand- rinse adhesive. ML resulted in lower μTBS for both adhesives. Materials (p < 0.01) and aging (p < 0.01) significantly influenced the distribution of failure modes. SEM analysis showed that specimens submitted to WS or ML showed features of degradation and fatigue at the fractured interface, depending on the adhesive. Conclusion: Mechanical loading had a negative effect on the bonding efficacy of both adhesives and influenced the fracture pattern, with specimens presenting a different fracture surface from that observed in water-stored specimens. [ABSTRACT FROM AUTHOR]

Background and Objective: Microleakage is one of the most important causes of failure in restoration and secondary caries. This study was conducted in order to compare dentinal microleakage of class II composite restorations using Universal Dental Adhesive, with and without liner. Methods: In this laboratory study, two Class II cavities were prepared in the mesial and distal surfaces of 48 healthy premolar teeth. Then, the samples were divided into 6 groups of 8 according to the application method of Single Bond Universal adhesive and liner: selective etching of enamel (SEE), self-etch (SE) technique, SEE technique and resin-modified glass-ionomer (RMGI) liner, SE technique and RMGI Liner, SEE technique and Flow Liner, and SE technique and Flow Liner. Restoration was done with Filtek Z250 composite. Microleakage was evaluated and compared using 2% fuchsine based on intensity 0 to 3. Findings: In the SEE group, 56.2% of restorations did not have microleakage. 31.2% had grade 3 microleakage and 12.5% had grade 1 microleakage. However, in the SEE+RMGI group, 81.25% and the SEE+Flow group, 81.2% of the restorations had no microleakage. In the SE group, 18.7% of restorations showed zero microleakage, 50% showed grade 3 microleakage, and 31.2% showed grade 2 microleakage. However, in the SE+RMGI group, 81.25% and in the SE+Flow group, 93.7% of the restorations did not have microleakage. The distribution of dentinal microleakage intensity between SEE and SE methods (p=0.067) and between SEE+RMGI and SEE+Flow groups (p=0.194) was not significant. However, in the SE+Flow and SE+RMGI groups, this difference was significant (p<0.001). Conclusion: The results of this study showed that in the method of using a liner with Universal adhesive, dentinal microleakage in class II composite restoration decreased. [ABSTRACT FROM AUTHOR]

To characterize whether the bonding performance and fatigue strength of resin-dentin interfaces created by a universal adhesive would be affected by different H 3 PO 4 -application times to more accurately assess long-term durability. Mid-coronal flat dentin surfaces with standardized smear-layers were produced on sound third molars, etched with 32% H 3 PO 4 for 0, 3 and 15 s, bonded with a mild universal adhesive (3M-ESPE) and restored with a nanofilled composite. Bonded specimens (0.9 × 0.9 mm) were stored in deionized water for 24 h and sectioned into beams for microtensile testing (n = 10). Resin-dentin beams were tested under tension until failure (0.5 mm/min) after 24 h or 6 month storage in artificial saliva at 37 ̊C. Bar-shaped resin-dentin beams (0.9 × 0.9 × 12 mm) were tested under 4-point-flexure initially at quasi-static loads (n = 22) and then under cyclic loads (n > 50). The stress-life fatigue behavior was evaluated using the twin-bonded interface approach by the staircase method at 4 Hz. Fractured interfaces and the tension side of unfractured beams were evaluated under SEM, along with the micro-morphology of the etched dentin surfaces and hybrid layers. Data were analyzed by ANOVA and Tukey test and Wilcoxon Rank Sum Test (α = 0.05). Quasi-static loads were limited to discriminate the bonding performance of resin-dentin interfaces. Application modes significantly affected etching patterns, fatigue strength, endurance limits and hybrid layer morphology (p < 0.001). Reductions in fatigue strength of self-etched bonded interfaces raise concerns about the true ability of universal adhesives to properly bond to dentin. [ABSTRACT FROM AUTHOR]

(1) Background: This study investigated the effect of the adhesive layer thickness and the length of resin tags on dentin bond strength of five universal adhesives applied in self-etch mode. (2) Methods: One hundred and fifty extracted human third molars were used. Five different universal adhesives were applied in self-etch mode on the dentin surface. Half of the specimens were subjected to an aging procedure for six months. A shear bond strength (SBS) test was performed and the results were statistically analyzed with a t-test and one-way ANOVA test. Scanning electron microscopy (SEM) was executed to measure the adhesive layer thickness and tag depth. (3) Results: No statistical differences were found between the five adhesive systems after a 24 h storage period, regardless of layer thickness and tag depth (p < 0.05). After 6 months of aging in water at 37 °C, Iperbond Max and Scotchbond Universal preserved the bond strength over time (p < 0.05), whilst the SBS of Iperbond Ultra, FuturaBond M+, and Ibond Universal decreased significantly after the aging period. No relation was observed between the adhesive thickness or tags' length on SBS. (4) Conclusions: Within the limitation of this study, the stability over time of the bond strength of universal adhesives depends on their compositions regardless of the adhesive layer thickness and/or tags' length. [ABSTRACT FROM AUTHOR]

• This is the first long-term clinical study evaluating the first commercial universal adhesive. • The etch-and-rinse (moist or dry) strategy showed better clinical behavior than the self-etch strategy. • For practicing dentists, it is recommended to etch enamel when using a universal adhesive. • FDI and USPHS criteria showed similar results after 5 years. To evaluate the five-year clinical performance of Scotchbond Universal Adhesive (SU; 3M Oral Care, St. Paul, MN, USA) in non-carious cervical lesions (NCCLs) using two evaluation criteria. Thirty-nine patients participated in this study. Two hundred restorations were assigned to four groups: SU-ERm: etch-and-rinse + moist dentin; SU-ERd: etch-and-rinse + dry dentin; SU-Set: selective enamel etching; and SU-SE: self-etch. A nanofilled composite resin was placed incrementally. The restorations were evaluated at baseline and after 5 years using both the World Dental Federation (FDI) and the United States Public Health Service (USPHS) criteria. The survival rates (retention/fractures) were calculated with the Kaplan-Meier and the log-rank test. For the secondary outcomes, Friedman repeated measures analysis of variance by rank was applied (α = 0.05). After 5 years the recall rate was 86%. The retention/fracture rates were 93% for Er m and ER d, 88.4% for SE et and 81.4% for SE. A significant difference was observed for SE vs. ER d and SE vs. ER m (p = 0.01). Also, marginal discoloration and adaptation showed significant differences with ER m and ERd resulting in fewer marginal discrepancies than SE (p < 0.05). After 5 years, the clinical behavior of the universal adhesive in the etch-and-rinse strategy was better when compared to the self-etch strategy. The use of selective enamel etching is highly recommended for the self-etch strategy. The FDI and USPHS evaluation criteria showed similar results after 5 years. [ABSTRACT FROM AUTHOR]

Objectives: To compare the clinical performance of a universal adhesive in class V non‐carious cervical lesions (NCCLs) using two surface treatment protocols (self‐etch [SfE] vs selective‐enamel‐etch [SelE]). Material and methods: Thirty‐three adults, each with ≥2 NCCLs, received one resin composite restoration utilizing a SfE universal adhesive and another utilizing the adhesive and SelE with 37% phosphoric acid. Restorations were evaluated for sensitivity, retention, marginal discoloration, marginal adaptation, and clinical acceptability through 24 months using Cochran‐Mantel‐Haenszel tests for stratified, ordered categorical outcomes. Results: Sixty‐six restorations (35 SfE, 31 SelE; 27 volunteers) were evaluated at 24 months. There were no significant differences between SfE and SelE for sensitivity, retention, marginal adaptation, or clinical acceptability. One SfE restoration was lost. Marginal adaptation was significantly worse at 24 months than baseline for SelE (P = 0.01), but not for SfE. Marginal discoloration was significantly worse for SfE (P = 0.02), but not for SelE. Sensitivity improved from baseline to 24 months for both groups (SelE P = 0.004, SfE P = 0.002). Conclusions: Twenty‐four‐month data indicated significantly reduced sensitivity for both groups, worse marginal discoloration for SfE, and worse marginal adaptation for SelE. No changes in retention or clinical acceptability were observed in either group. All retained restorations were clinically acceptable at 24 months. Clinical Significance: Both self‐etch and selective enamel etch techniques with a universal adhesive produced clinically acceptable results in resin composite restorations for NCCLs over 2 years. [ABSTRACT FROM AUTHOR]

Aim: The aim of this clinical trial was to evaluate and compare the performance of a universal adhesive with different adhesive strategies in the restoration of non-carious cervical lesions (NCCLs) over a 36-month period. Material and method: One hundred sixty-five NCCLs in 35 patients (13 female, 22 male) with at least 3 lesions each were included in this study. Three groups were formed according to the adhesive strategy used (n = 55): selective-etch mode, etch-and-rinse mode, or self-etch mode of a universal adhesive, Single Bond Universal. The same nanofilled resin composite, Filtek Ultimate, was used for all restorations by a single operator. The restorations were evaluated by two calibrated examiners at baseline and at 6, 12, 18, 24, and 36 months in accordance with the modified USPHS criteria. The chi-square test was used for intergroup comparison and Cochran's Q test for intragroup comparison (∝ = 5%). Results: At 36 months, the recall rate was 98.1% and three restorations, one from each group, had failed because of retention loss (P > 0.05). The self-etch mode group showed 17 bravo scores for both marginal staining and marginal adaptation after 3 years, which was significantly different from the selective-etch and etch-and-rinse groups (P < 0.05). For all groups, the only statistically significant difference was found when baseline and 36-month evaluations were compared in terms of marginal staining (P = 0.000). When the marginal adaptation values at 36 months were compared with those at the baseline, statistically significant differences were found in the etch-and-rinse and self-etch mode groups (P < 0.05). Neither secondary caries nor postoperative sensitivity was observed at any recall. Conclusion: All adhesive modes showed similar retention rates. Although all restorations were clinically acceptable, restorations in self-etch mode showed less satisfying performance for marginal staining and marginal adaptation. Clinical relevance: At the end of 36 months, the Single Bond Universal adhesive received acceptable scores according to the modified United States Public Health Service (USPHS) criteria. However, clinicians should be aware that its use in self-etch application mode tends to result in marginal staining and marginal deterioration when compared with etch-and-rinse and selective-etch application modes. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the bond strength of fiber posts luted with a one-step self-etching adhesive with the push-out test after phosphoric acid conditioning of the root dentin. Thirty-six single-rooted teeth were endodontically treated. Teeth were sectioned perpendicularly to the cementoenamel junction, and a 10-mm post space was prepared with a calibrated bur. Specimens were then divided into three groups according to the adhesive protocol: A, total-etch three steps; B, self-etch one step; and C, 32% phosphoric acid conditioning and self-etch one step. Fiber posts were luted with self-curing resin- based cement. Teeth were cut in 1-mm slices and pushed until failure with an Instron machine. Results were statistically analyzed with the ANOVA and Bonferroni tests (P < .05). Two additional specimens from each group were examined under the scanning electron microscope (SEM). The 32% phosphoric acid significantly intiuenced the push-out bond strength of fiber posts luted with self-etch adhesives (P < .05). SEM analysis showed a continuous hybrid iayer with resin tags and iaterai branches in groups A and C, while group B showed smear iayer dissolution with poor intiitration of the tubules. [ABSTRACT FROM AUTHOR]

Background/purpose: The restoration longevity depends on a high dentin-composite bond quality. This study investigated learning outcomes when using etch-and-rinse and self-etch adhesives among general practitioners in a hands-on bonding test course.Methods: We recruited 30 general practitioners to perform shear bond strength (SBS) tests using five adhesives: one Peak® Universal Bond (PUB) etch-and-rinse and four Futurabond DC, Single Bond universal (SBU), Versa Optibond (VOB), and Tetric-N Bond Self-Etch (TNS) self-etch adhesives. SBS tests were conducted at pre-demonstration (pre-demo), post-demonstration (post-demo), and 24-h storage (delayed bonding) stages. SBS data were analyzed with paired Student's t-tests. We defined 17 MPa as "qualified bond strength (QBS)". The percentages of samples with SBS achieving QBS were analyzed using Mantel-Haenszel chi-square tests. The fracture surfaces of the samples were examined by scanning electron microscopy (SEM).Results: Using PUB caused no significant differences in SBS between pre- and post-demo samples, whereas the SBS of the two self-etch adhesives (SBU and VOB) improved in post-demo samples (p < 0.05). SBU showed the highest percentage of samples with SBS achieving QBS in all three groups (pre-demo = 70%, post-demo = 83%, and delayed bonding = 76.5%). The QBS percentages of VOB and TNS notably improved from 0% (pre-demo) to 71.4% and 23.5% (post-demo), respectively. SEM indicated bubble-like defects at the dentin-resin interfaces in cases of low SBS.Conclusion: Bonding performance is both operator- and product-dependent. The continuing education hands-on course does help dentists to improve the bond strength especially when the self-etch system is used. [ABSTRACT FROM AUTHOR]

Contemporary adhesives use etch-and-rinse, self-etch, and multimode adhesive strategies. Simplified and universal adhesives present lower bond strength to dentin than conventional, two-bottle etch-and-rinse adhesives. The purpose of this study was to evaluate bonding performance of simplified and universal adhesives to dentin after modifying their application protocol (multiplying applications and extending application time). Adhesive layer thickness (ALT) and shear bond strength (SBS), as well as the correlation between these parameters was calculated. Two universal (Single Bond Universal and Prime & Bond One Select) and two self-etch adhesives (Adper Easy One and Xeno V) were tested. Significant differences in ALT were detected between the adhesives, as well as within the same adhesive between study groups. Tested adhesives presented the thinnest adhesive layer when applied 2 times in 20 s. Single Bond Universal obtained the highest SBS results of all adhesives. Most adhesives (except for Prime & Bond One Select) obtained the highest SBS, when applied two or three times in 40 or 60 s, respectively. No correlation between the ALT and SBS was found. The study showed that increasing the number of applications and extending the application time of self-etch and universal adhesives can be recommended to improve their performance. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the immediate bond effectiveness of universal adhesives to unground and ground enamel surfaces in different etching modes, through shear bond strength (SBS) tests and scanning electron microscopy observations. Three universal adhesives, a conventional two‐step self‐etch adhesive, and a conventional single‐step self‐etch adhesive were compared. Human enamel specimens from lower anterior teeth were divided into four groups and subjected to the following treatments: (i) unground enamel in self‐etch mode; (ii) ground enamel in self‐etch mode; (iii) unground enamel in etch‐&‐rinse mode; and (iv) ground enamel in etch‐&‐rinse mode. Bonded assemblies were subjected to SBS testing. All the adhesives showed significantly higher SBS values in etch‐&‐rinse mode than in self‐etch mode, regardless of whether enamel was unground or ground. The influence of the enamel surface condition on SBS was different in different etching modes. Without pre‐etching, all tested materials showed lower SBS values in unground enamel than in ground enamel. In etch‐&‐rinse mode, no significant differences in SBS values were observed between unground enamel and ground enamel for any of the adhesives tested. Phosphoric acid pre‐etching before application of self‐etch adhesives to an unground enamel surface is essential to enhance initial enamel bond effectiveness. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate internal and marginal adaptation of high-viscosity bulk-fill composites to enamel and dentin with a self-etch (SE) and an etch-and-rinse adhesive (ER) without and with artificial aging. 128 MOD cavities in extracted human molars were prepared, randomly assigned to 8 groups (n = 16), bonded with either OptiBond FL (OFL, ER) or Xeno V+ (X, SE), and restored in 4 mm horizontal bulk layers with SonicFill (SF), Tetric EvoCeram Bulk fill (TEC), and x-tra fil (XF). Incremental layering technique with Premise (P) served as control. Half of the specimens each (n = 8) were subjected either to water storage (1 day, 37 °C) or prolonged storage (180 days) and thereafter thermocycling. Replicas were analyzed for marginal gap formation. After sectioning, interfacial adhesive defects were assessed. Results were statistical analyzed. (1) Internal adaptation: Except for TEC/OFL at enamel without artificial aging, no significant differences between bulk-fill composites and the control were observed. All groups at dentin with OFL showed less internal adhesive defects than that with X (p < 0.05). (2) Marginal adaptation: No significant differences were observed between bulk-fill composites and control except for P after artificial aging (p > 0.05). All other composites, regardless of artificial aging, formed significantly more marginal gaps at enamel with X compared to with OFL (p ≤ 0.05). Simplified restorations with high-viscosity bulk-fill composite showed comparable internal and marginal adaptation to incrementally placed fillings. A superiority of the 3-step ER approach was seen compared to the 1-step SE adhesive irrespective of the bulk-fill composite used. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the 24-month clinical performance of universal adhesives on the restoration success of Class I carious lesions. Materials and methods: Five different universal adhesives (Gluma Bond Universal (GU), Clearfil Universal (CU), Prime&Bond Elect Universal (PU), All bond Universal (AU), and Single Bond Universal (SU)) were used in the self-etch and etch-and-rinse modes in 42 patients. The study was conducted with 10 groups, with 20 restorations in each group. The restorations were evaluated at baseline and during a 24-month recall using World Dental Federation (FDI) and the US Public Health Service (USPHS) criteria. The changes in the parameters were analyzed using the chi-square test. Results: At the end of 24 months, there was no loss of restoration in any group. According to the USPHS, there was no difference in the baseline and 24-month clinical behavior of the restorations (P ˃ 0.05). However, according to the FDI, when adhesives were used in the self-etch mode, three adhesives (GU, SU, PU) showed marginal incompatibility, and one adhesive showed (GU) marginal discoloration between baseline and the 24-month follow-up evaluation (P < 0.05). There was no significant difference after 24 months between etch-and-rinse and self-etch groups according to the results based on both the USPHS and FDI criteria (P ˃ 0.05). Conclusions: The 24-month clinical performance of the evaluated universal adhesives depends on the adhesive strategy. Clinical relevance: This study helps clinicians to decide in which mode (etch-and-rinse or self-etch) universal adhesives can be safely used. [ABSTRACT FROM AUTHOR]

Introduction: Self-etch adhesives have become increasingly popular in orthodontics as the process of etching and priming is combined in one step, thus eliminating the steps of washing and drying that are necessary after conventional etching. With an increased use, the need to study the bracket failure rates with such systems in comparison with the conventional system is necessary. The primary aim of this review is to compare the bracket failure rates of self-etch adhesives with conventional twostep adhesives: The secondary objectives being the comparison of bracket failure rates among the upper and lower arches and also the bracket failure rates between fixed mechanotherapy in cases of extraction and non extraction. Methodology: Data sources: The search strategy for this literature review was carried out according to the standard Cochrane systematic review methodology for all randomized and controlled clinical trials. All volumes of the European Journal of Orthodontics, American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, Seminars in Orthodontics, and other orthodontic journals were searched. Inclusion and exclusion criteria were applied when considering the studies to be included in this review. Data selection: Primary outcome measure was the rate of bracket failures when self-etch primers and conventional adhesive systems were used while the secondary outcome measures included the failure rates observed between the maxilla and the mandible. Results: Ten randomized controlled trials were selected as eligible studies, and only qualitative analyses were performed because of the diversity of the interventions and outcome measures. Eight studies showed no significant alterations in bracket failure rates when bonded with self-etch and conventional adhesives. One study showed a decreased rate of bracket failure when self-etch adhesives were used, while one study showed a significant increase in the rate of bracket failure when self-etch adhesives were used. Conclusion: There was no difference in the failure rates or survival time of brackets bonded with conventional adhesive systems and self-etch adhesive systems. [ABSTRACT FROM AUTHOR]

Abstract The objective of this study was to evaluate the effect of sonic application of universal adhesives on the enamel microshear bond strengths (µSBS), in situ degree of conversion (DC) and etching pattern. Ninety-six extracted third molars were sectioned in four parts (buccal, lingual, proximal) and divided into 12 groups, according to the combination of 1) adhesive system (All-Bond Universal [ABU], G-Bond Plus [GBP], Prime&Bond Elect (PBE), and Scotchbond Universal Adhesive [SBU]), and 2) adhesive application mode (manual active etch-and-rinse [M-ER], manual active self-etch [M-SE], and sonic vibration self-etch [S-SE]). Specimens were stored in water at 37 °C during 24 h and tested at 1.0 mm/min (µSBS). DC was evaluated in the enamel-resin interfaces using micro-Raman spectroscopy. The enamel-etching pattern was evaluated under a field- emission scanning electron microscope. Data were analyzed with two-way ANOVA and Tukey's test (α = 0.05). S-SE application increased µSBS and DC for all universal adhesives when compared to M-SE (p < 0.05). S-SE application resulted in mean bond strengths that were statistically similar to those obtained with the respective ER application mode (p > 0.05). A deeper enamel-etching pattern was observed for all universal adhesives in the etch-and-rinse strategy. An improvement in etching ability was observed in S-SE application compared to M-SE application. In light of the improved performance of universal adhesives when applied sonically in SE mode, selective enamel etching with phosphoric acid may not be crucial for their adhesion to enamel. The sonic application of universal adhesives in self-etch mode may be a practical alternative to enamel etching. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study is to evaluate the interface between resin and hard dental tissues obtained by using two adhesive systems. Material and method. Ten extracted human molars were bonded using a total etch adhesive (Adper Single Bond 2, 3M ESPE) and a self-etching agent (Futurabond U DC, VOCO), after artificially preparing MOD cavities on them. The composite build ups were constructed using Filltek Z550 nanohybrid composite from 3M ESPE. Teeth were embedded in epoxy resin, using special vacuum equipment, then metallographic grinded to a certain point of interest and polished. The samples were analyzed using a Carl Zeiss Optical Microscope (Axio Imager A1M) and the image acquisition was made using a dedicated microscope camera (Canon Powershot A640) and dedicated software (Axio Vision). Results. Resin-enamel bonds were uniform over the entire surface on both adhesive systems whereas resin-dentin bonds resulted using the total etch system are of inferior quality (there are micro spaces between dentin and resin that range from 6,18μm to 24,12μm) than the ones resulted using the self-etch adhesive, in which case the bonds were uniform and well adapted with no signs of micro spaces. Conclusions. Resin-dentin bonds resulted using a total etch adhesive may reduce the quality of the restoration, thus being susceptible to marginal infiltration and debonding over time. [ABSTRACT FROM AUTHOR]

Objectives To evaluate whether selective dentin etching protocols using reduced phosphoric acid (H 3 PO 4 ) etching-times would affect the resin-dentin interaction of a universal adhesive to improve long-term bonding effectiveness. Methods Mid-coronal flat dentin surfaces were produced on sound third molars, selectively etched with 32% H 3 PO 4 for 3, 5, 10 or 15 s and bonded with a universal adhesive (Scotchbond Universal, 3 M ESPE: SU). SU in self-etch mode and a three-step etch-and-rinse adhesive were used as control groups. Bonded specimens were stored in deionized water for 24 h and sectioned into beams (cross sectional area of 0.7 mm 2 ). Micro-tensile bond strength test (n = 6) and nanoleakage evaluation were performed immediately, after thermocycling or 6-month storage in artificial saliva. Energy dispersive X-ray analysis (n = 6) was performed to determine the residual Ca-content ratio at the hybrid layers and scanning electron microscopy (SEM) was used to observe the micromorphology of the etched dentin surfaces before and after SU application. Data were analyzed by ANOVA and Tukey test (α = 0.05). Results Selective dentin etching for 3 s improved the interaction depth of the tested universal adhesive without overexposing demineralized collagen or reducing Ca-content availability at the bonded interface. The improved immediate bond strengths of the selective etching protocol remained significantly higher ( p  < 0.05) after long-term aging producing hybrid layers without significant differences ( p  > 0.05) in silver uptake levels compared to those produced on non-etched dentin. Conclusions Despite the adjunctive conclusion that universal adhesives used in self-etch mode produce superior long-term dentin bonding compared to the etch-and-rinse mode, selective etching for 3 s with conventionally used H 3 PO 4 improves dentin bonding effectiveness; nonetheless, longer etching times should be strictly avoided. [ABSTRACT FROM AUTHOR]

This study investigated the effect of rubbing force magnitude on dentin bond strengths of multi-mode adhesives applied in self-etch mode. Seventy-two extracted human molar teeth were used. Two different universal adhesives Single Bond Universal (SB) and Clearfil Universal (CL) were applied onto dentin surfaces in three different modes: without rubbing (NR), rubbing with 40 gf (gramforce) (40) or 80 gf (80) load. Teeth were restored with a resin composite. Half of the specimens were subject to thermal aging (10,000 cycles). Microtensile bond strength was measured and data were statistically analyzed with two-way analysis of variance and Tukey's test (α=0.05). Baseline bond strength values for CL adhesive were improved by rubbing (40 and 80 gf) as compared to no rubbing (p<0.05). Rubbing did not significantly improve bond strength values for SB, regardless of aging (p>0.05). Rubbing improves bonding performance of some universal adhesives to dentin when applied in self-etch mode. [ABSTRACT FROM AUTHOR]

Aim The aim of the present study was to evaluate the effect of the application of a hydrophobic resin on the microleakage of Cl V composite resin restorations using a universal adhesive system applied in the self-etch ( SE) and etch-and-rinse ( ER) modes. Method Cl V cavities were prepared on the buccal surfaces of 64 human premolar teeth and divided into four groups ( n = 16): ER, ER with hydrophobic resin ( ERH), SE, and SE with hydrophobic resin ( SEH). Microleakage at occlusal and gingival margins was evaluated using 0.5% methylene blue dye penetration technique under stereomicroscope at 40 × magnification. Data were analyzed using Kruskal-Wallis and Mann-Whitney U-tests ( P < 0.05). Results At the enamel margins, the ER group had significantly less microleakage than the SE and SEH groups ( P < 0.001), but had no significant difference compared with the ERH group ( P > 0.05). There was also no statistically-significant difference between the SE and SEH groups ( P > 0.05). At the dentinal margins, the SE group had significantly less microleakage compared with the ER ( P < 0.001) and ERH groups ( P = 0.005). Furthermore, microleakage of the SEH group was significantly less than the SE group ( P < 0.001). Conclusion Applying an extra layer of hydrophobic resin significantly decreased microleakage in the SE mode at the dentinal margin, but had no significant effect in the ER mode. [ABSTRACT FROM AUTHOR]

Aim. The purpose of this in vitro study was to evaluate microleakage of two different adhesive systems: self-etch and etch-and-rinse, using the optic microscopy. Materials and methods. Six sound upper premolar teeth had MOD cavities prepared. The teeth were divided into two groups of three teeth each and two restorative systems were used: 1) Filtek™ Silorane/Silorane System Adhesive (3M ESPE); 2) Premise™ Packable /OptiBond FL (KERR). All restorative materials were placed following manufacturers' recommendations. After restoring them, the teeth were stored for 5 years in an oven in distilled water at 37°C. Before the tests, the apex was sealed with wax and the teeth were covered with nail polish except 1 mm around the edge restorations. Then, they were immersed in 0.5% alkaline solution of fuchsin for 24 hours. After sectioning, the microleakage evaluation at enamel margin was made using an optical microscope Olympus KCX41 (Olympus America Inc.) at a magnification of 4x and 10x, the method of granting a semiquantitative score of dye penetration on a scale from 0-3. Data were statistically analyzed using Kruskal-Wallis test. Results, conclusions. Microleakage was present in both groups, scores 2 (infiltration dye the entire length threshold cervical enamel) and 3 (infiltration threshold cervical enamel and expanding axial wall towards the pulp chamber), registering only in the Filtek Silorane (FS) group who applied to Silorane system, adhesive Self-etch adhesive system. The most effective adhesive system to reduce the microleakage at marginal threshold cervical MOD restorations on enamel, was etch-and-rinse system, OptiBond FL. [ABSTRACT FROM AUTHOR]

The objective was to compare bond strengths of adhesives with/without thermocycling and to analyze the micromorphology of resindentin interfaces. Flat dentin surfaces were prepared and divided into eight groups to bond with four etch-and-rinse adhesives (Optibond FL, Adper Scotchbond Multi-Purpose, Optibond Solo Plus, and Single Bond 2) and four self-etch adhesives (Clearfil SE Bond, Adper SE Plus, Clearfil S3 Bond and Adper Easy Bond). Specimens were further divided into two subgroups subjected for with/ without thermocycling and then subjected to both micro-tensile test and resin-dentin interface evaluation. The results revealed that there were significant differences in bond strength between the groups with and without thermocycling for all etch-and-rinse groups and for the Adper Easy Bond self-etch group (p<0.01). Clearfil SE Bond demonstrated highly durable bond strengths. Furthermore, more silver ion uptake was observed at the resin-dentin interfaces for all etch-and-rinse adhesives and Adper SE Plus and Adper Easy Bond after thermocycling. [ABSTRACT FROM AUTHOR]

Introduction The aim of this study was to evaluate marginal sealing ability of newly introduced Dyad Flow flowable composite and compare to total-etch and self-etch adhesive system at the coronal and apical margins of class V resin composite restorations. Material and Methods A standard class V cavity (3 mm mesiodistal width, 3 mm occlusogingival height and 1.5 mm axial depth) was prepared on the buccal surface of freshly extracted sound human teeth. Occlusal and gingival margins of the cavities were located in enamel and cementum/dentin, respectively. Teeth were randomly assigned into the three groups (n=10) and restored with different composite materials following the manufacturer's instructions: group I was restored with nanohybrid resin composite using total-etch bonding agent; group II was restored with nanohybrid resin composite using self-etch technique; group III was restored with flowable composite (Dyad Flow), respectively. After finishing and polishing, the teeth were coated with nail varnish and immersed in rhodamine B dye and sectioned longitudinally. Dye penetration was examined under stereomicroscope and scored separately for occlusal and gingival margins on a 0-3 ordinal scale. Data were analyzed with Kruskal-Wallis, Mann-Whitney and Wilcoxon tests (a=0.05). Result Statistical analysis showed that specimens restored with the total-etch and self-etch adhesive systems revealed reduced leakage at the coronal margin. At the apical margin, Dyad Flow showed greater leakage than other groups. Conclusion Newly introduced flowable composite Dyad Flow showed inferior adhesive bond with enamel and dentin compared to total-etch and self-etch techniques. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this study was to evaluate the clinical effectiveness of a one-step HEMA-free self-etching adhesive (SEA) placed with a micro-fine hybrid resin composite in Class II restorations. The restorations were compared intraindividually with 2-step HEMA containing SEA-giomer restorations. Material and methods: Fifty-four patients with at least one pair of two similar Class II cavities participated (30 men, 24 women; mean age 57.1yrs). A total of 115 Class II composite restorations were placed with (1) a one step HEMA-free adhesive and a micro-fine hybrid resin composite (Gbond/Gradia Direct: 60; GG) and (2) a 2-step HEMA-containing SEA and a giomer (FL Bond/Beautifil: 55; FB). Each participant received in a randomized way at least one restoration with each of the experimental materials. The restorations were evaluated at baseline and yearly during a 6 year followup using modified USPHS criteria. Results: During the 6 years, 111 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Fourteen failed restorations (12.6%) were observed during the follow up, 5 GG (8.5%; 4 premolar and 1 molar teeth) and 9 FB (17.7%; 1 premolar and 8 molar teeth) (p <0.05). Annual failure rate at 6 years were 1.4% for GB and 3.0% for FB. Main reasons of failure were bulk fracture of resin composite for FB and tooth fracture for GB. Significance: The HEMA-free SEA-hybrid RC restorations showed good clinical durability in Class II cavities after 6 years. The HEMA-containing SEA-giomer restorations showed a rather high failure frequency. [Copyright &y& Elsevier]

The aim of this study was to evaluate microtensile bond strength ( μ TBS) to dentine, interfacial nanoleakage expression, and stability after ageing, of two-step vs. one-step self-etch adhesives. Human molars were cut to expose middle/deep dentine, assigned to groups ( n = 15), and treated with the following bonding systems: (i) Optibond XTR (a two-step self-etch adhesive; Kerr), (ii) Clearfil SE Bond (a two-step self-etch adhesive; Kuraray), (iii) Adper Easy Bond (a one-step self-etch adhesive; 3M ESPE), and (iv) Bond Force (a one-step self-etch adhesive; Tokuyama). Specimens were processed for μ TBS testing after 24 h, 6 months, or 1 yr of storage in artificial saliva at 37°C. Nanoleakage expression was examined in similarly processed additional specimens. At baseline the μ TBS results ranked in the following order: Adper Easy Bond = Optibond XTR ≥Clearfil SE = Bond Force, and interfacial nanoleakage analysis showed Clearfil SE Bond = Adper Easy Bond = Optibond XTR> Bond Force. After 1 yr of storage, Optibond XTR, Clearfil SE Bond, and Adper Easy Bond showed higher μ TBS and lower interfacial nanoleakage expression compared with Bond Force. In conclusion, immediate bond strength, nanoleakage expression, and stability over time were not related to the number of steps of the bonding systems, but to their chemical formulations. [ABSTRACT FROM AUTHOR]

The objective of this article is to evaluate the resistance to degradation of resin-dentin bonds formed with three one-step adhesives. Flat, mid-coronal dentin surfaces were bonded with the self-etching adhesives [Tokuyama Bond Force (TBF), One Up Bond F Plus (OUB), and G-Bond (GB)]. The bonded teeth were subjected to fatigue loading, chemical degradation, and stored in distilled water for four time periods (up to 12 months). Specimens were tested for microtensile bond strength and microleakage. Fractographic analysis was performed by scanning electron microscopy. Bonded interfaces were examined by light microscopy using Masson's trichrome staining. An atomic force microscope was employed to analyze phase separation and surface nanoroughness (Ra) at the polymers. Vickers microhardness and the degree of the conversion (DC) were also determined. ANOVA and multiple comparisons tests were performed. Bond strength significantly decreased after the chemical challenge, but not after load cycling. Aging decreased bond strength after 6 months in TBF and GB, in OUB after 12 months. An increase of the nonresin protected collagen zone occurred in all groups, after storing. TBF showed the highest roughness, microhardness, and DC values, and GB showed the lowest. Mild self-etch one-step adhesives (TBF/OUB) showed a higher degree of cure, lower hydrophilicity, and major resistance to degradation of resin-dentin bonds when compared to highly acidic self-etching adhesive (GB). [ABSTRACT FROM PUBLISHER]

Background and Aims: The purpose of this experimental study was to investigate the shear bond strength of three new adhesive systems to enamel and dentin of permanent human teeth using three new etch and rinse and self-etch adhesive systems. Materials and Methods: Sixty intact caries-free third molars were selected and randomly divided into 6 groups. Flat buccal and lingual enamel and dentin surfaces were prepared and mounted in the acrylic resin perpendicular to the plan of the horizon. Adhesives used in this study were Tetric N-Bond, AdheSE and AdheSE-One F (Ivoclar/Vivadent, Schaan, Liechtenstein). The adhesives were applied on the surfaces and cured with quartz tungsten halogen curing unit (600 mW/cm2 intensity) for 20 S. After attaching composite to the surfaces and thermocycling (500 cycles, 5-55?C), shear bond strength was measured using a universal testing machine at a crosshead speed of 0.5 mm/min. The failure modes were examined under a stereomicroscope. The data were statistically analyzed using t-test, one-way ANOVA, Tukey and Fisher's exact tests. Results: In enamel, Tetric N-Bond (28.57±4.58 MPa) and AdheSE (21.97±7.6 MPa) had significantly higher bond strength than AdheSE-One F (7.16±2.09 MPa) (P<0.0001). Tetric N-Bond had higher bond strength than AdheSE but there was not any significant differences between them (P=0.093). In dentin, there were significantly differences among all adhesives (P<0.001). Tetric N-Bond (20.62±3.03 MPa) showed the highest and AdheSEOne F (6.54±1.13 MPa) had the lowest value. The bond strength in enamel was higher than that observed in dentin and the difference was significant in Tetric N-Bond (P=0.044) and AdheSE (P=0.000) groups. There were no significant differences in the mode of failures among groups (P>0.05). Conclusion: Shear bond strength to dentin in Tetric N-Bond (etch and rinse system) was higher than self-etch adhesives (AdheSE and AdheSE-One F). The bond strength to enamel and dentin in two-step self-etch (AdheSE) was higher than one-step self-etch (AdheSE-One F) [ABSTRACT FROM AUTHOR]

Taschner M, Nato F, Mazzoni A, Frankenberger R, Falconi M, Petschelt A, Breschi L. Influence of preliminary etching on the stability of bonds created by one-step self-etch bonding systems. Eur J Oral Sci 2012; 120: 239-248. © 2012 Eur J Oral Sci We evaluated the effects of preliminary etching of dentine on the stability of the bond created by one-step self-etch adhesives under different storage conditions. Adper Easy Bond (3M ESPE) and iBond Self-Etch (iBond SE; Heraeus Kulzer) were applied with an etch-and-rinse (i.e. after preliminary phosphoric acid etching for 15 s) or a self-etch approach. Resin-dentine bonded specimens were sectioned perpendicularly to the adhesive interface according to the 'non-trimming technique'. Beams were stored in artificial saliva for 24 h, 6 months, or 1 yr at 37°C, or in 10% NaOCl for 5 h at room temperature, and then stressed until failure; the microtensile bond strengths were calculated. Interfacial nanoleakage of additional teeth was evaluated using light microscopy or transmission electron microscopy. Adper Easy Bond showed higher bond strength than iBond SE, regardless of the dentine treatment. Similar microtensile bond strength results were obtained for teeth subjected to artificial ageing in 10% NaOCl for 5 h at room temperature and for teeth stored in artificial saliva for 6 months at 37°C. The additional etching step increased the microtensile bond strength for Adper Easy Bond and iBond SE. This study supports the use of one-step adhesives on etched dentine because of the increased bond strength compared with their application onto smear-layer-covered dentine, regardless of storage conditions. [ABSTRACT FROM AUTHOR]

This study was aimed to determine the effectiveness of grinding and pre-etching in promotion of adhesion to human intact enamel using the self-etch adhesive (SEA) Adper Easy Bond (3M ESPE). Etch-and-rinse adhesive Adper Single Bond (3M ESPE) served as control. Composite cylinders (AP-X Kuraray) were built and after 24 h micro-shear bond strengths (MSBS) were measured. Bonding interfaces were evaluated under scanning electron microscope (SEM). For evaluation of average roughness (Pa) and morphological analysis, treated enamel surfaces were observed under SEM and confocal laser scanning microscope (CLSM) with 3D surface profiling. Highest bond strengths were obtained by pro-etching and grinding showed a less significant role. Phosphoric acid (PA) etching compare to grinding created significantly rougher surface (Ra: 0.72 and 0.43 μm respectively). Therefore, this study recommends pre-etching the intact enamel prior to application of the adhesive instead of grinding. [ABSTRACT FROM AUTHOR]

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Van Landuyt KL, Peumans M, De Munck J, Cardoso MV, Ermis B, Van Meerbeek B. Three-year clinical performance of a HEMA-free one-step self-etch adhesive in non-carious cervical lesions. Eur J Oral Sci 2011; 119: 511-516. © 2011 Eur J Oral Sci Despite the fact that one-step adhesives are currently used routinely in clinical practice, long-term studies on their clinical performance are scarce. The objective of this randomized controlled clinical trial was to test the hypothesis that a 2-hydroxyethyl methacrylate (HEMA)-free one-step self-etch adhesive performs worse than a conventional multistep etch-and-rinse adhesive. Two-hundred and seventy-six non-carious cervical lesions in 52 patients were restored with a micro-hybrid composite (Gradia Direct; GC). These restorations were bonded in random order either with the HEMA-free one-step adhesive G-Bond (GC) or with the 'gold-standard' (control) three-step adhesive Optibond FL (Kerr). The restorations were evaluated after 6, 12, 24, and 36 months of clinical service regarding retention, marginal adaptation, microleakage, caries occurrence, and sensitivity. After a medium-long period of 3 yr, similar success in clinical performance was observed for the simplified all-in-one adhesive and the conventional three-step adhesive. However, the one-step adhesive exhibited significantly more incisal marginal defects and discolorations. Whereas marginal degradation appeared to arrest for the multistep etch-and-rinse adhesive after 12 months, the enamel margins of the restorations bonded with the one-step self-etch adhesive continued to deteriorate. These incisal marginal defects were, however, small and could easily be removed by polishing. For both adhesives, large and sclerosed lesions appeared to be at higher risk of retention loss. [ABSTRACT FROM AUTHOR]

Introduction: The continuous appearance of new restorative materials, especially from the composite resins class, and the development of the correspondent adhesive systems has brought major changes about the way in which cavities are being prepared. Thus, a big part of the restorative therapy in modem dentistry is based on the composite resins adhesion to the hard dental tissues, achieved through adhesive systems. The purpose of the present study was to evaluate the adhesion strength to the dentin of four commercial adhesive systems. Experimental: Twenty primary, caries-free and without previous restorations, molars and premolars were used in the study. For testing we used three total-etch adhesives and a self-etch one. In order to obtain standard samples, a Teflon® mould was designed and manufactured, which helped us to apply the same resin volume on the same dentin surface for all the teeth used in this test. Results: Statistical analysis was completed using one- way ANOVA, Tukey and Bonferroni tests. Significantly differences were observed between Point4®/Optibond SoloPlus® and the rest of the samples, the former achieving higher values. Conclusions: The self-etch adhesive system did not match the performances of the total-etch adhesives, at least not in this study. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: One-step self-etch adhesives are the most recent generation of adhesives introduced onto the market. The objective of this randomized controlled clinical trial was to test the hypothesis that a one-step self-etch adhesive performs equally well as a conventional three-step etch&rinse adhesive (gold standard). Methods: Fifty-two patients had 267 non-carious cervical lesions restored with Gradia Direct Anterior (GC). These composite restorations were bonded either with the ‘all-in-one’ adhesive G-Bond (GC) or with the three-step etch&rinse adhesive Optibond FL (Kerr). The restorations were evaluated after 6 and 12 months clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. A logistic regression analysis with generalized estimating equations was used to account for the clustered data (multiple restorations per patient). Results: The recall rate at 1 year was 98%. The statistical analysis revealed a relatively low patient factor, indicating that supplementary information could be obtained from the additional restorations placed per patient. The retention rate for G-Bond was 98.5% compared to 99.3% for Optibond FL, due to the retention loss of two and one restorations, respectively. There were no significant differences between the two adhesives regarding the evaluated parameters except for the presence of small enamel marginal defects with G-Bond. Conclusions: After 12 months, the simplified one-step G-Bond and the three-step Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation of marginal adaptation, and G-Bond exhibited more small enamel marginal defects. [Copyright &y& Elsevier]